Unenhanced and Contrast-Enhanced Ultrasonography During Hepatic Transarterial Embolization and Chemoembolization With Drug-Eluting Beads

Journal Article · Wed Dec 15 00:00:00 EST 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-9918-7· OSTI ID:21428882

Moschouris, Hippocrates ^[1]; Malagari, Katerina ^[2]; Kornezos, Ioannis; Papadaki, Marina Georgiou ^[1]; Gkoutzios, Panagiotis ^[3]; Matsaidonis, Dimitrios ^[1]

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1. General Hospital 'Tzanio', Department of Radiology (Greece)
2. University of Athens, Second Department of Radiology, 'Attikon' Hospital (Greece)
3. NHS Foundation Trust, Department of Interventional Radiology, Guy's and St. Thomas' Hospital (United Kingdom)

The purpose of this study was to describe and evaluate the findings of unenhanced ultrasonography (US) and contrast-enhanced ultrasonography (CEUS) when these modalities are applied during transarterial embolization (TAE) or transarterial chemoembolization (TACE) of liver tumors. Sixteen tumors (9 hepatocellular carcinomas, 5 metastases from colorectal cancer, and 2 hemangiomas) were treated with TAE with microspheres and/or TACE with drug-eluting beads. All of these lesions were studied with intraprocedural unenhanced US and 12 were studied with intraprocedural CEUS. For the latter, a second-generation echo-enhancer (SonoVue; Bracco, Milan, Italy) and a low mechanical index technique were used. Intraprocedural findings were classified according to an arbitrary scale and were compared with pretreatment imaging (CEUS and computed tomography or CEUS and magnetic resonance imaging), with postembolization angiography, and with follow-up results. On unenhanced intraprocedural US, 13 of 16 tumors demonstrated intralesional high-level echoes of varying extent. These feature correlated poorly (r = 0.33, p = 0.097) with and generally underestimated the actual extent of necrosis. Exceptionally, high-level echoes that occupied the largest part of the treated lesions were associated with >50% tumor necrosis. Intraprocedural CEUS clearly depicted immediate partial or complete disappearance of tumor enhancement as a result of TAE/TACE. Three of 6 tumors with complete devascularization on postembolization angiogram showed residual enhancement on intraprocedural CEUS. Intraprocedural CEUS findings correlated closely (r = 0.91, p = 0.002) with follow-up findings. Intraprocedural sonography, particularly with echo-enhancers, could be used for intraprocedural monitoring in selected cases of liver tumors that undergo TAE or TACE.

• OSTI ID: 21428882
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 33, Issue 6; Other Information: DOI: 10.1007/s00270-010-9918-7; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANGIOMAS
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
COMPUTERIZED TOMOGRAPHY
DRUGS
EMBOLI
HEPATOMAS
LIVER
METASTASES
MICROSPHERES
NECROSIS
NMR IMAGING
ULTRASONOGRAPHY
BODY
CARCINOMAS
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
GLANDS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
RADIOLOGY
TOMOGRAPHY